New Strategy calls for increased resources and a broadening of the donor base

Contents

1. NEWS

An audit of grants to Nigeria performed by the Office of the Inspector General has found that despite efforts by the Secretariat and despite significant investments, there are still major deficiencies in internal controls. The OIG said that the implementation arrangements were not adequate for a large federal state. The Secretariat responded that it believes its has implemented measures to adequately minimize the risks.

3. COMMENTARY

A recent report from UNAIDS said that by 2020, countries should devote 8% of its HIV resources to reducing human rights barriers to accessing services. Currently, less than 1% of Global Fund grant funds is spent on programs to reduce human rights barriers. We have to do more and we have to do it better, says Ralf Jürgens. In this commentary, Ralf describes an intensive effort that the Global Fund is implementing in 15-20 countries, as well as other initiatives the Fund has planned.

4. NEWS

Canada will host The Global Fund’s fifth replenishment conference in Montreal on 16 September 2016. In making the announcement, Canada also indicated that it would increase its pledge to the Fund by 20%.

5. NEWS

Although The Global Fund has succeeded in raising awareness of community, rights and gender issues, and in getting these issue included in country dialogues and concept notes, there are still challenges in translating these achievements into impact in programs on the ground. This information was included in a report provided to the Board at its meeting in Abidjan on 26-27 April.

6. ANALYSIS

The Global Fund has almost completely withdrawn from funding programs in the Russian Federation. This has had an adverse effect on services to people who inject drugs, sex workers, and men who have sex with men. There is some evidence that efforts to empower these communities are meeting with some success. In the absence of a transition plan, discussions continue among NGOs and communities concerning how to do more with less.

7. NEWS

To mobilize increased resources is one of the four objectives of the new Strategy 2017-2022. The Global Fund will focus on raising funds from a more diverse pool of donors and will promote greater domestic investment in the fight against the diseases.

8. NEWS

In March, the Board approved additional funding for two shortened grants. The Board also approved funding from the 2014-2016 allocations for two TB/HIV grants to Liberia.

7. NEWS

Author:

Anna Maalsen

10 May 2016

The Fund will also promote greater domestic investment

The Global Fund’s new Strategy calls for the Fund to mobilize increased resources, to diversify its donor base, and to promote greater domestic investment in the fight against the diseases.

The Board adopted the new Strategy at its meeting in Abidjan on 26-27 April (see GFO article.)

There are four operational objectives under this strategic objective, as follows:

Attract additional financial and programmatic resources for health from current and new public and private sources.

Support countries to use existing resources more efficiently and to increase domestic resource mobilization.

Implement and partner on market-shaping efforts that increase access to affordable, quality-assured key medicines and technologies.

Support efforts to stimulate innovation and facilitate the rapid introduction and scale-up of cost-effective health technologies and implementation models.

This article briefly summarizes each operational objective.

Attract additional resources for health

The Global Fund will continue to focus on mobilizing resources through its traditional donors, the public sector. Government donors have been the largest contributors to The Global Fund since its inception. Advocacy efforts will emphasize the Fund’s value-for-money model, its global reach, and the impact and effectiveness of investments as a result of its country-driven approach.

Additionally, the Global Fund will attempt to expand its donor base by trying to convince emerging economies to support regional or country-specific efforts. For this purpose, different financing models such as indirect contributions through co-investment or targeted technical assistance approaches will be developed.

Increasing contributions to the Global Fund from private sector continues to be a priority in the new Strategy. The Global Fund expects that this will come through the expansion of (RED) program, as well as the rollout of something new: the “Major Gifts Strategy.” The latter will target foundations, trusts and high-net-worth individuals with options to give directly to certain countries, regions, or priorities; or to contribute to country-led vehicles for sustainable health financing.

Domestic resource mobilization and more efficient use of existing resources

Increasing domestic investments in health continues to be a priority for The Global Fund in the new Strategy. The Fund plans to evolve the old co-financing policy in a manner which will best leverage domestic resources for health. Using lessons learned from the Equitable Access Initiative, the new policy will target countries that have low investment in health, but high burden of disease. Domestic funding requirements will vary depending on country income classification and disease burden.

To support the implementation of its co-financing policy, the Fund will help to coordinate the provision of technical assistance in certain high burden countries to ensure that they have strong national health financing underlying their strategic plans and that the three diseases are effectively integrated into national heath insurance schemes.

The Fund will continue to strengthen other components of its domestic resource mobilization strategy by supporting country-led advocacy efforts, including providing technical support and funding to civil society, community, and other advocates.

The Fund will continue to support innovative financing mechanisms such as Debt2Health, and will explore the use of social impact bonds or blended financing models. The Strategy says that a social impact bond might be used to incentivize some governments to eventually take over funding of successful programs targeting key and vulnerable populations. Another example is the use of credit guarantees to allow governments to access the same pricing and terms for key health products after the Global Fund has transitioned out of a country.

The Strategy explains that through implementation of initiatives in its market shaping strategy, The Global Fund will continue to drive market transparency through innovative data-sharing mechanisms, and will leverage its market position to support global forecasting efforts and build healthier global markets for health products.

The Strategy says that this will be achieved by The Global Fund continuing to impact upon both the supply and demand side of the market through its pooled procurement mechanism. The Fund will continue to ensure market transparency through its the price and quality reporting mechanism and other resources.

The Strategy also says that framework agreements negotiated by countries under the PPM are likely to be offered to all recipient countries who wish to procure quality-assured medicines and technologies with domestic funding.

The Global Fund aims to ensure its resources are used effectively and efficiently as possible, and that includes critical support to scaling up products that have been found to be more cost-effective or have greater clinical benefits to current treatments.

The Global Fund Strategy 2017-2022 outlines its commitment to continue working with partners such as UNITAID in supporting innovative technologies and implement strategic “roadmaps” for the scale-up of key products. The ultimate aim is to support lowering of prices and stimulate sustainable demand for new products. Through its market shaping strategy, the goal is to reduce the risk for new market entry for key products and accelerate scale-up.

The Strategy also emphasizes the role of The Global Fund in supporting countries and its partners in adopting differentiated approaches to care and treatment of the three diseases through innovative models of service delivery. The Global Fund will act as a “connector” in support of this by linking countries with experts and evidence from cost-effectiveness modelling to assist countries in country-driven health technology assessments.